Ch 47 Flashcards
(25 cards)
What are 5 early symptoms of CHF
Fatigue Shortness of breath Venous distention Peripheral edema Pulmonary edema
What are 4 complications of CHF
Ventricular dysfunction
Reduced cardiac output
Insufficient tissue perfusion
Fluid retention
There are 4 classes of heart failure and they are
Class I: no limitation of ordinary physical activity
Class II: slight limitation of physical activity, normal activity producers fatigue, dyspnea, palpitations or angina
Class III: marked limitation of physical activity, produces symptoms
Class IV: symptoms occur at rest
To achieve therapeutic goals in heart failure what 3 actions should take place
Treat correctable underlying causes
Implement non drug measures
Drug therapy if no response from first two
What are 6 non drug measures to treat heart failure
Limit salt intake to 2 mg a day Reduce caloric diet Bed rest Regular mild exercise Avoid alcohol Avoid excessive fluids
Beta blockers must be used with CAREFUL CONTROL… What are 3 things they can help improve
Left ventricular ejection
Exercise tolerance
Slow progression of heart failure
Spironolactone (aldosterone receptor blocker) can reduce symptoms, decrease hospitalizations, prolong life in patients with what
Moderate to severe heart failure
Aldosterone promotes 4 things and activates what
Myocardial remodeling Myocardial fibrosis Vascular fibrosis Baroreceptors dysfunction Activates sympathetic nervous system and suppresses NE uptake in heart
Myocardial remodeling does what
Impairs pumping of heart
Myocardial fibrosis does what
Increases risk of dysrhythmias
Vascular fibrosis does what
Decreases arterial elasticity and increases hypertension
Ionotropic agents have what 2 benefits
Increase force of myocardial contraction
Improve performance of failing heart
What are 3 types of ionotropic agents
Cardiac glycosides
Sympathomimetics
Phosphodiesterase inhibitors
What is the medication used for as an example for cardiac glycosides
Digoxin
What are the two drugs that are on the Sympathomimetics class
Dopamine
Dobutamine
What drug falls under phosphodiesterase inhibitor class
Inamrinone
Digoxin is a naturally occurring compound and affects what properties of the heart
Mechanical and electrical
Digoxin has a high incidence of toxicity and has positive inotropic action which means what
Increases force of ventricular contraction and increases CO
Digoxin inhibits what two things
Sodium
Potassium atpase
Digoxin by inhibition causes calcium to accumulate in heart muscle which causes what
Increased contractile force of the myocardium
All patients with heart failure should take what (and if edema is present should take with a diuretic too)
Ace inhibitor
Aspirin and NSAIDS decrease effects of what drugs
Diuretics
All patients with class II or III should take this class of drugs (along with ace inhibitor and diuretic)
Beta blockers
This drug can be used in combination with diuretics, ace inhibitors, and beta blockers
Digoxin
